Seper László, Schwab Richárd, Kiattavorncharoen Sirichai, Büchter Andre, Bánkfalvi Agnes, Joos Ulrich, Piffkó József, Kruse-Loesler Birgit
Department of Cranio-Maxillofacial Surgery, University of Muenster, Waldeyerstr, 30, 48149 Muenster, Germany.
Head Face Med. 2007 Oct 18;3:36. doi: 10.1186/1746-160X-3-36.
Soft tissue sarcomas in the head and neck region are rare and often present a difficult differential diagnosis. The aim of our presentation is to point out the complexity of the diagnosis, treatment and follow up.
An eighty-seven year old female patient was referred to our unit with a fast growing brownish lump on the face. Four months beforehand, a benign fibrous histiocytoma (BFH) had been removed from the same location by excision biopsy with wide tumour-free resection margins. Excision biopsy of the recurrent lesion revealed a malignant fibrous histiocytoma (MFH). Radical tumour resection was completed by extended parotidectomy and neck dissection; the skin defect was covered by a regional bi-lobed flap. No adjuvant radio- or chemotherapy was administered. Full functional and cosmetic recovery was achieved; follow-up has been uneventful more than two years postoperatively.
Malignant transformation of BFH is extremely rare and if so, extended radical surgery may give a fair chance for a favourable outcome even in patients with advanced age.
头颈部软组织肉瘤较为罕见，且常常在鉴别诊断方面存在困难。我们此次报告的目的是指出诊断、治疗及随访的复杂性。
一名87岁女性患者因面部快速生长的褐色肿块被转诊至我院。四个月前，在同一部位通过切除活检并保证切缘无瘤进行了广泛切除，切除的是良性纤维组织细胞瘤（BFH）。复发病变的切除活检显示为恶性纤维组织细胞瘤（MFH）。通过扩大腮腺切除术和颈部清扫术完成了根治性肿瘤切除；皮肤缺损用局部双叶皮瓣覆盖。未进行辅助放疗或化疗。实现了功能和外观的完全恢复；术后两年多的随访情况良好。
BFH发生恶性转化极为罕见，即便发生，扩大根治性手术即使对于高龄患者也可能有较好的预后机会。
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